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Although criticized as highly expensive additions to an already costly health care system, robotic surgery systems begin to earn their keep.

Rating

3 Star

Although criticized as highly expensive additions to an already costly health care system, robotic surgery systems begin to earn their keep.

Our Review Summary

This newspaper article describes increasing adoption of the daVinci surgical robot in the state of Minnesota.

It provides useful specifics to demonstrate the increased use. It also discusses two incidents in which the device appears to have been used successfully and appropriately.

But the article suffers from several key flaws:

  • The issue of high cost and uncertain benefits is central to the controversy about the daVinci’s use. Yet specific costs are not mentioned and the inconclusive outcome data are not examined at all.
  • The reporter allows the source’s assertion that hospital stays are cut in half stand unchallenged. 
  • The reporter did not speak with an opponent of the daVinci’s wider adoption. Only physicians who use the device are quoted. The story does not mention the likely conflict of interest both sources have as users and surgeons at hospitals that have made the risky, substantial investments in the devices, partly as marketing tools.  
  • The article provides no takeaway for readers. Patients facing heart surgery, prostate removal or hysterectomies do not have information to help them make informed decisions about whether the device might be appropriate in their cases.

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The article says the daVinci devices have "a million dollar price tag." But it does not say whether any of this cost is passed along to insurers and patients in the form of higher costs.

The story also mentions the possibility that hospital costs will be reduced but does not provide any data to back it up.   

Nonetheless, at least it nodded in the direction of costs.  

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The report does not summarize findings of benefits and harms. It also allows a surgeon to say it has the benefit of reducing hospital time by half without pressing for some detail or source.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The story does not mention negative outcomes that may be associated with the daVinci machines. It does not indicate whether complication rates are higher, lower or equal. 

The story also fails to mention the potential harm if the machine is used to justify a hospital’s investment or support surgical revenues regardless of whether it’s the best use for a particular patient.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The article mentions briefly that there is little evidence to show that the daVinci improves outcomes. Some details are necessary in a story centered on its increasing adoption.

The only evidence given to support the daVinci’s use is a physician’s statement that he’s "seen enough cases to believe it’s making a difference." No evidence cited to defend the claim that use of the device reduces hospital costs by half.

Two anecdotes are provided that forecast successful outcomes. 

Does the story commit disease-mongering?

Satisfactory

The article focuses on an extraordinary application of the daVinci device–in a highly trained athlete whose disease and lifestyle led to a decision to use the machine. This unusual story may create the impression that the robot is a life-saving necessity for hospitals and patients. 

Nonethless, the story did not exaggerate the condition being treated.  

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The article quotes two physicians, both of whom use the machine–and work at hospitals that have invested in the machines.

The reporter should have talked to at least one surgeon who has declined to use the device, and one independent researcher with no conflict of interest who could summarize the findings of safety and efficacy.

Finally, there is some federal data about negative outcomes with the device–including at least one unnecessary death early in the device’s development–that should have been drawn on. 

Does the story compare the new approach with existing alternatives?

Not Satisfactory

In the two cases cited, the article at least briefly describes what treatment without the machines would have been like. In each case, it’s open-heart surgery, which carries higher risks in the patients described.

But it would have been valuable to know where robot-assisted surgery falls among treatment choices–including non-robot-assisted minimally invasive surgeries and non-surgical options–for someone found with clogged coronary arteries, for instance.  

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The article does a good job of specifying how many daVinci surgery robots are available in Minnesota–and which facilities have them.

Does the story establish the true novelty of the approach?

Satisfactory

The story makes no false claims of novelty. It does a good job of describing the state of the machines’ use in the paper’s circulation area.

Does the story appear to rely solely or largely on a news release?

Not Applicable

There does not appear to be a press release associated with this report.

Total Score: 4 of 9 Satisfactory

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